Mucinous carcinoma of the breast: A multifaceted study with special reference to histogenesis and neuroendocrine differentiation

Kato, Noriko; Endo, Yasushi; Tamura, Gen; Katayama, Yousei; Motoyama, Teiichi

doi:10.1046/j.1440-1827.1999.00975.x

Cited by 26 publications

(26 citation statements)

References 26 publications

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“…In our series, MUC1 was expressed in the majority of breast cancer cases using two different antibodies; one directed against the carbohydrate side chain (MUC1) and the other directed against the apomucin protein backbone (MUC1-core). This is in concordance with previous studies using different antibodies directed against tandem repeat peptides, 11 carbohydrate side chain 41 of the extracellular domain or against the cytoplasmic domain. 42 We found associations between MUC1 expression and tumour grade and ER status where such relationships have previously been reported indicating high correlation between MUC1 expression and functional differentiation of the tumour cells.…”

Section: Discussionsupporting

confidence: 93%

Expression of mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and their prognostic significance in human breast cancer

et al. 2005

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Mucins are a large family of glycoproteins expressed by many epithelial cells and their malignant counterparts. Much interest has been focused on expression of its members in breast cancer because of their potential role as prognostic indicators and their involvement in cancer therapy. We have examined 1447 cases of invasive breast carcinoma with a long-term follow-up, using tissue microarray (TMA) technology and immunohistochemistry to evaluate the expression profiles of several mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and to assess their prognostic value. We detected MUC1 expression in 91% of tumours. MUC1 overexpression was associated with a lower grade, smaller tumour size, a higher oestrogen receptor (ER)-positive phenotype and absence of both regional recurrence and distance metastasis. The subcellular localization but not the level of expression had a prognostic value in predicting outcome. The aberrant cytoplasmic and membranous localization of MUC1 was associated with poor outcome compared with apical localization, which is the normal physiological site of expression. MUC2 expression was noticed in only 8.3% of all cases and was restricted to the cytoplasm of the tumour cells. An inverse trend was identified between MUC2 expression and lymph node stage and vascular invasion status. On excluding cases of mucinous carcinoma from the analysis, the inverse association with vascular invasion was still defined and in addition an inverse association with ER status emerged. MUC3 expression was detected in 91% of cases and its expression was associated with increased local recurrence, and lymph node stage. The membranous expression of MUC3 was found to be a potentially poor prognostic feature, with higher grade and poorer Nottingham Prognostic Index (NPI), and negative ER expression. MUC4, MUC5AC and MUC6 were expressed in 95, 37 and 20% of cases, respectively. Apart from an association between MUC4 expression and tumour grade and between MUC6 and ER-negative tumours, no other associations with any clinicopathological variables were found. Apart from the higher expression of MUC2 and MUC6 in mucinous carcinomas, no association was found between the expression of different mucins and tumour type. No association between the level of expression of any of the studied mucins and patient outcomes has been identified. In conclusion, most breast carcinomas express MUC1, MUC3 and MUC4. Among the various mucins expressed in breast cancer, MUC1 and MUC3 are potential prognostic indicators, MUC1 having the strongest relationship with patient outcome.

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Section: Discussionsupporting

confidence: 93%

Expression of mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and their prognostic significance in human breast cancer

et al. 2005

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“…In the literature, there are a few large series analyzing this phenomenon in mucinous carcinoma, and many authors concluded that there was no difference between mucinous carcinoma with or without neuroendocrine differentiation in terms of predictive value, growth patterns, and estrogen receptor status, 5,7 while another recent series did not analyze these prognostic parameters. 8 The expression of neuroendocrine markers is not unique to mucinous carcinoma of the breast. This phenomenon has been described in other breast carcinomas, including ductal carcinoma in situ (termed endocrine ductal carcinoma in situ, 9 ); the small-cell undifferentiated carcinoma that resembles small-cell carcinoma or Merkel cell carcinoma; infiltrating lobular carcinoma; and low-grade insular ductal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] The significance of neuroendocrine differentiation in mucinous carcinoma has been controversial, with some authors reporting a difference in patients' age and prognosis, 4,6 while other authors concluded that no difference existed. 5,7,8 In this study, we further evaluated the clinicopathological differences between pure mucinous carcinoma with or without neuroendocrine differentiation.…”

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confidence: 99%

Neuroendocrine differentiation in pure type mammary mucinous carcinoma is associated with favorable histologic and immunohistochemical parameters

et al. 2004

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Mucinous carcinoma of the breast is a specific good prognostic type malignancy occurring in elderly patients. Neuroendocrine differentiation has long been described in mucinous carcinoma, but the significance of such finding is uncertain. We evaluated the neuroendocrine differentiation profiles of 38 cases of pure mucinous carcinoma and compared the clinicopathological differences between those with and those without neuroendocrine differentiation. The parameters assessed included patients' age, tumor size, nuclear grade, axillary lymph node status at time of diagnosis, percentage area of intratumoral mucin, and the expression of estrogen and progesterone receptors, cerbB2 oncoprotein, and three neuroendocrine markers, namely neurone-specific enolase, chromogranin, and synaptophysin by immunohistochemistry. Patients' outcome and follow-up period were also documented. Of the 38 cases of pure mucinous carcinoma, 28, 11 and six cases showed positive staining for 1, 2 and 3 of the neuroendocrine markers. For all the groups with variable neuroendocrine differentiation and compared to those without such differentiation, they all showed older patients' age, higher proportion of tumors with lower nuclear grade, lower incidence of axillary lymph node metastasis, a higher progesterone receptor, and lower cerbB2 oncoprotein expression. No difference was detected between tumor size, intratumoral mucinous area, and estrogen receptor status. In all, 37 patients did not have distant metastases or local recurrences at the end of follow-up period, while one patient with coexisting high-grade ductal carcinoma in situ at time of diagnosis died of breast carcinoma. Our findings suggest that the identification of neuroendocrine differentiation in pure mucinous carcinoma is associated with more favorable histologic and immunohistochemical parameters.

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“…In fact, it is well known that some mucinous carcinomas of the breast are associated with neuroendocrine differentiation. [10][11][12] The tumor cells are often of low nuclear grade, with relatively little mitotic activity. The nuclear and cytoplasmic features of the tumor cells resemble those of low grade neuroendocrine tumors occurring in other organ systems.…”

Section: Discussionmentioning

confidence: 99%

Fine Needle Aspiration Cytology of Ductal Breast Carcinoma with Neuroendocrine Differentiation

Poon

Kong³

2002

Acta Cytologica

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Mucinous carcinoma of the breast: A multifaceted study with special reference to histogenesis and neuroendocrine differentiation

Cited by 26 publications

References 26 publications

Expression of mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and their prognostic significance in human breast cancer

Expression of mucins (MUC1, MUC2, MUC3, MUC4, MUC5AC and MUC6) and their prognostic significance in human breast cancer

Neuroendocrine differentiation in pure type mammary mucinous carcinoma is associated with favorable histologic and immunohistochemical parameters

Fine Needle Aspiration Cytology of Ductal Breast Carcinoma with Neuroendocrine Differentiation

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